Venous Leg Ulcer Excellence in Treatment Program

Abstract

Venous leg ulcers occur due to improper functioning of the calf muscle or the venous system and are usually associated with venous reflux and hypertension. They are a major origin of ulcers, causing 70%-90% of chronic wounds. Lower extremity disease accounts for 873,000 hospital admissions with an average length of stay of 10.7 days (CDC, 2007).

Treatment often lasts over a year with an estimated cost of $3 billion dollars/year. The psycho-social impact of these wounds includes social isolation related to the odor, frequent clinic visits, loss of work and inability to perform activities of daily living. Venous ulcers can be very painful with pain lasting long after the wound has closed. Reoccurrence rates are 57-97%, based on the source sited (Bryant & Nix, 2007).

Despite the prevalence of venous ulcers, no consensus exists regarding universally accepted wound treatment protocols (Paine, 2009). Guideline-directed chronic disease care is not the norm (Wagner, 1999), supported Jones’ (2007) finding inconsistency in healthcare providers following evidence-based treatment protocols.

The Doctorate of Nursing Practice (DNP) degree is the subject of much debate, but this project is an example of the DNP validating acquired knowledge by developing a comprehensive program with global impacts on health. The purpose of this research is to validate the use of the Trajectory Theory of Chronic Illness in developing a treatment algorithm, resulting in consistent, evidence-based practice across all healthcare settings. The standardization of assessment, treatment, pain management, and prevention interventions are tracked using an outcome focused database. The final algorithm will represent user friendly, evidence-backed venous ulcer care. Innovative nursing interventions are introduced, resulting in building a practice team of the patient, family, and providers. The significance of this research will be recognized in better health outcomes, faster healing rates, fewer reoccurrences and ease of the economic healthcare burden.